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Education * Dialogue * Independence
INTERNATIONAL
Life returns - in pieces
Doctors in Gaza work around barriers to repair the damage compounded by years o f conflict
BY EVA BARTLETT
STREET NEWS SERVICE
on a Saturday; now there are at least 30.
ICRC figures show that in 2008, 63 patients
GAZA CITY, Palestine
received 71 prosthetic limbs (some had
n a Saturday morning in Gaza city,
multiple amputations), and the center
the Artificial Limb and Polio Center
served, 1,500 patients. In the first half of
(ALPC) is filled with people waiting
2009,1,018 patients have come to the
to see the director, Dr. Hazem Al-Shawwa.
centre, 53 for prosthetic limbs.
Following consultation with him and with
the specialist in prosthetics and orthotics
rehabilitation from the International
Committee of the Red Cross (ICRC), many
will begin thelong road to treatment.
“It was the second day of the war,” says
Omar Al-Ghrub (24), referring to the three
weeks of Israel attacks in the winter of
2008-2009. “I was working that day,” he >
said. By day he worked in the Al-Waleed
marble and granite factory northwest of
Gaza cijty, and by night served as its
watchman.
A missile struck, and Ghrub lost both his
legs. Six months later, he waits for the
stumps to heal enough to begin the process
of fitting artificial legs, and learning to walk
anew.
Loay Al-Najjar, 22, also lost both his legs.
At 11 pm Jan. 13, Najjar was tiyingto help
his sister evacuate a house that had been hit
by shelling in the Khoza’a region, east ofT
Khan Younis. “I was hit by a drone missile,”
says Najjar. His legs were lacerated with
A t the artificial limbs center in Gaza,
shrapnel. But he is one of theluckier ones;
he was able to travel to Saudi Arabia where
he received treatment for three months, and
H
• ar tificial "leg»;1-...... ....... ..... .
— ------
Ghrub and Najjar are among the many
waiting for a consultation this particular
Saturday. The artificial limb center is unique
in that it makes and fits the limbs on the
premises. With the help of staff from the
ICRC and Doctors Without Borders , it also
provides physiotherapy and other support
The eerttre is overcrowded -v it is the only
one of its kind. The waiting listhas
lengthened dramatically since the Israeli
attacks on Gaza. Gaza’s Ministry of Health
says between 120-150 new patients have had
to have amputations following the Israeli
attacks on Gaza. Gerd Van de Velde, head of
the ICRC’s physical rehabilitation team in
Gaza, says the number could rise with
patients whose wounds worsen.
“Even now we are getting new patients,”
says Van de Velde. “Some patients are
having problems with their stumps as they
were not carecLfor properly during their
initial treatment due to the hectic situation.
At the time, treatment was focused on life
saving.”
In January 2008, five to 10 patients came
“We have 146 patients on the waiting list,
including 101 with war wounds,” says Van de
Velde. “Of these, over 50 percent are above
the knee amputations.” Blast injuries
become even more complicated, because
shrapnel must be extracted from the stump
of the limb before it can heal énough for
prosthetics treatment.
A few years ago, the center used its
funding to pay all the costs of the materials.
Nearly allcamefrom a specialist company in
Germany, some were bought at twice their
usual price from an Israeli importer.
Now, the ICRC, which began working with
the center in November 2007, supplies most
of the materials, buying directly from the
manufacturer, and also facilitating transfer
through-Israel. The Céntre also gets help
from the United Nations Relief and Works,
Agency (UNRWA), Handicap International
and Islamic Relief.
Van de Velde sees early hospital care, or
the lack of it, as the origin of the problem
for many of the patients. In a crisis, he , said,
Send two Palestinians to India for an
internationally recognized 18-month training
program. Vande Velde says the ICRC plans
to send three more to be trained next year,
with the aim of building .a pool of qualified
technicians.
All sorts of people were injured in the last
assault “During thé first and second
Intifadas (Palestinian uprisings, 1987-1991
knd then from September 2000), most of
the injuries were among the shebab (young
men>,” says Mohammed Ziada. “But in this
last war, most of the injuries were people
other than shebab: elderly, children,
women...”
Farah pointé to severfo siege-related
difficulties the center faces. The artificial
limb center uses hundreds of différent parts,
plastics and materials to make the
prosthetic arms and legs. “Without even just
one Of the materials, the limb cannot be
made. We don’t have the materials or the
chemieals in Gaza to make the limbs.” Israel
often prevents or greatly delays materials
from entering, says Farah,
Walking through a storage room, Farah
points out various empty shelves. Among
clusters of different weaves of stocking net
cloth used iii the making of limbs, size 10
shelf sits empty. “We haven’t had size 10 for
E M A D B A D W A N /IP S
the last month,” Farah says.
Also absent are artificial foot parts L23,
unavailable for the last 10 days, and R24 and
R25, depleted for the last two mopths. “We
"ReïpTîPstuîosewiroiîeecrnei^xn^nosïr^™
other hospitals, focusing on quality of post-
says Farah. _ g
_ . . .
surgical physiotherapy care and ensuring
Gerde Van de Velde says, however, that
that patients receive the treatment that they “not oné patient had to wait because of a
need.” Likewise, Doctors Without Borders is lack of material.” Items like the cloth can be
working throughout the Gaza Strip to
substituted by a closely related size, he says.
provide post-operation wounds care and
He admits there are restrictions on certain
physiotherapy.
chemicals, but adds that thèse are more
At the artificial limbs center, faking a
related to international law, and delayed by
pause from casting and sculpting limbs,
other bureaucratic procedures regarding the
Nabil Farah and Mohammed Ziada, two of
transport of chemicals.
four specialists in prosthetics,-take turns to
Farah cites some sample costs: a below-
demonstrate work at the center. The
the-knee prosthetic is about $800. An ahove-
specialists have both studied abroad, in
the-knee limb is twice as much. An arm
Germany and in India, and want the trainees costs $1,200. Yet these seemingly expensive
here to be sent for specialized studies. But?
limbs cost a fraction of what they might in
with the siege on Gaza and the sealed
other countries.
borders, it has become difficult to leave
“Our salaries are very low,” says Farah.
Gaza.
“We aren’t working for the money, obviously.
Likewise, says Farah, many specialists
We’re working for the many Palestinians
want to come to Gaza to train technicians in who need limps and therapy.”
malting and working with prosthetic limbs,
but they cannot enter because of the. siégé.
Courtesy o f Inter Press Service, in agreement
But on July 1, after much coordination with
with the International Network o f Street
the Israeli authorities, the ICRC1 was able to
Papers © Street News Service: www.street-
“patients are evacuated quickly to make
room for new patients. They did not receive
the treatment and follow-up physiotherapy
that they needed.”
. The ICRC has now taken on a second,
hospital-based project. “We’ve started with
Shifa hospital, and hope to expand to Gaza’s
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